Jobs: csp claims inquiry

Job DescriptionJob DescriptionSummary:To serve as a liaison between IPA and its Members and Providers. Ensures that all Members and Providers receive a level of service that exceeds their expectations. Respond to and resolve questions and problems from current Providers/Members, or their representative and other appropriate parties.Duties and...

Job DescriptionJob DescriptionSummary:To serve as a liaison between IPA and its Members and Providers. Ensures that all Members and Providers receive a level of service that exceeds their expectations. Respond to and resolve questions and problems from current Providers/Members, or their representative and other appropriate parties. Duties and...

Job DescriptionJob DescriptionWe are seeking a proactive and detail-oriented Claims/Administrative Assistant to join our dynamic team. In this role, you will play a crucial part in supporting our organization by handling a diverse range of administrative tasks, including managing claims, performing intake procedures for new clients, answering phones, and...

Job Description - Customer Service Professional (32 hours/week) (3179624) **Job Description** Customer Service Professional (32 hours/week) ( **Job Number:** 3179624 ) **Description** For over 30 years, AllWays Health Partners has delivered value to our members and worked to improve access to care and coverage. As a member of Mass General Brigham, AllWays is...

**Claims Adjuster** Dolphin Drive - Waukesha County, 1801 Dolphin Drive, Waukesha, Wisconsin, United States of America Req #1894 Monday, February 7, 2022 ***Community Care has adopted a mandatory COVID-19 vaccination policy. This policy requires that all Community Care, Inc. employees verify they are fully vaccinated or have an approved medical or religious...

Position Overview This position is responsible for the data entry and system adjudication of provider claims including but not limited to professional, ancillary and facility claims. The position is responsible for the end-to-end processing of claims. Job Description Process claims involving medical and/or surgical services; screens for complete...

Job DescriptionJob DescriptionPosition Type: Direct HireLocation: Montebello, CA (Hybrid after initial training onsite is completed)Hourly Rate: $24 - 30/HR depending on years of experienceSchedules Available: 6AM - 3PM, 7AM - 4PM, 8AM - 5PMRequirements:Minimum 2 - 3 years of previous claims examiner experience, not medical billing.Experience communicating...

Summary Claims Analyst is responsible for accurate and timely research of all providers claim inquiries according to policies, process instructions and system requirements, regulatory reporting, and acts as a liaison between internal stakeholders for associated claims processes. Candidate will respond to all incoming inquiries and coordinate with other...

- The Claims Specialist will be responsible for reviewing claims processed by the outside vendor, including resolving provider appeals/disputes. Performs root cause analysis for all provider projects to identify areas for provider education and/or system (re)configuration. Initiates and follows through with resolution of all pended claims, (re)pricing,...

Empower. Unite. Care.MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.About NYC Health + HospitalsMetroPlusHealth provides the highest...

What Youll Do * Investigate and submit new claims to insurance carriers by reviewing first reports of loss and supporting materials to accurately identify insurance exposure and determine applicable insurance policy * Demonstrate critical thinking while adhering to Client established claims processes. * Apply existing knowledge to assist with higher...

- The Claims Specialist will be responsible for reviewing claims processed by the outside vendor, including resolving provider appeals/disputes. Performs root cause analysis for all provider projects to identify areas for provider education and/or system (re)configuration. Initiates and follows through with resolution of all pended claims, (re)pricing,...

- The Claims Specialist will be responsible for reviewing claims processed by the outside vendor, including resolving provider appeals/disputes. Performs root cause analysis for all provider projects to identify areas for provider education and/or system (re)configuration. Initiates and follows through with resolution of all pended claims, (re)pricing,...

- The Claims Specialist will be responsible for reviewing claims processed by the outside vendor, including resolving provider appeals/disputes. Performs root cause analysis for all provider projects to identify areas for provider education and/or system (re)configuration. Initiates and follows through with resolution of all pended claims, (re)pricing,...

What You’ll Do* Investigate and submit new claims to insurance carriers by reviewing first reports of loss and supporting materials to accurately identify insurance exposure and determine applicable insurance policy* Demonstrate critical thinking while adhering to Client established claims processes.* Apply existing knowledge to assist with higher...

What You’ll Do* Investigate and submit new claims to insurance carriers by reviewing first reports of loss and supporting materials to accurately identify insurance exposure and determine applicable insurance policy* Demonstrate critical thinking while adhering to Client established claims processes.* Apply existing knowledge to assist with higher...

What You’ll Do* Investigate and submit new claims to insurance carriers by reviewing first reports of loss and supporting materials to accurately identify insurance exposure and determine applicable insurance policy* Demonstrate critical thinking while adhering to Client established claims processes.* Apply existing knowledge to assist with higher...

Job DescriptionJob DescriptionSummaryThe claims adjuster is responsible for the adjusting of claims, in accordance with outside regulations and the contractual obligations of the Health Plans and/or the IPAs. Researches, reviews and contacts provider services for problem claims and issues, as needed. Suggests process improvements to management and is a...

Job DescriptionJob DescriptionSummaryClaims Analyst is responsible for accurate and timely research of all providers claim inquiries according to policies, process instructions and system requirements, regulatory reporting, and acts as a liaison between internal stakeholders for associated claims processes. Candidate will respond to all incoming inquiries...

The Claims Processor ensures efficient claims processing for services provided. They perform a spectrum of clerical chores that culminate in determinations for payment of claims to providers for authorized services rendered; specifically for HMO patients, encounter claims from PCP’s or capitated specialists, ancillary claims, emergency room, shared risk,...